Journal
DIABETES RESEARCH AND CLINICAL PRACTICE
Volume 118, Issue -, Pages 1-11Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2016.05.001
Keywords
Southern Africa; Cross-sectional study; Epidemiology
Categories
Funding
- Wellcome Trust Clinical PhD Fellowship [100141/Z/12/Z]
- Johns Hopkins University
- Bill and Melinda Gates Foundation [19790.01]
- Medical Research Council [MR/K012126/1] Funding Source: researchfish
- Wellcome Trust [100141/Z/12/Z] Funding Source: Wellcome Trust
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Aims: To determine the prevalence of and risk factors for diabetes mellitus and examine its diagnosis and management in the study communities. Methods: This is a population-based cross-sectional study among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Diabetes is defined as a randomblood glucose concentration (RBG) >= 11.1 mmol/L, or RBG < 11.1 mmol/L but with a self-reported prior diabetes diagnosis. For individuals with a prior diagnosis of diabetes, RBG < 7.8 mmol/L was considered to be an acceptable level of glycaemia. Results: Among 45,767 Zambian and 12,496 WC participants the age-standardised prevalence of diabetes was 3.5% and 7.2% respectively. The highest risk groups identified were those of older age and those with obesity. Of those identified to have diabetes, 34.5% in Zambia and 12.7% in WC were previously unaware of their diagnosis. Among Zambian participants with diabetes, this proportion was lower among individuals with better education or with higher household socio-economic position. Of all those with previously diagnosed diabetes, 66.0% in Zambia and 59.4% in WC were not on any diabetes treatment, and 34.4% in Zambia and 32.7% in WC had a RBG concentration beyond the recommended level, >= 7.8 mmol/L. Conclusions: The diabetes risk factor profile for our study communities is similar to that seen in high-income populations. A high proportion of individuals with diabetes are not on diabetes treatment and of those on treatment a high proportion have high glycaemic concentrations. Such data may assist in healthcare planning to ensure timely diagnosis and management of diabetes. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
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